| Entity Name: | G M KAZIM INSURANCE AGENCY INC. |
| Jurisdiction: | Illinois |
| Entity Type: | Corporation - Domestic BCA |
| Status: | Dissolved |
| Date Formed: | 03 Dec 2015 |
| Date of Dissolution: | 10 May 2024 |
| Company Number: | CORP_70424037 |
| File Number: | 70424037 |
| Type of Business: | All Inclusive Purpose |
| Date Status Change: | 10 May 2024 |
| Place of Formation: | ILLINOIS |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| G M KAZIM INSURANCE AGENCY 401(K) P/S PLAN | 2021 | 810731585 | 2022-03-31 | G M KAZIM INSURANCE AGENCY | 5 | |||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 810731585 |
| Plan administrator’s name | G M KAZIM INSURANCE AGENCY |
| Plan administrator’s address | 1140 N MCLEAN BLVD STE E, ELGIN, IL, 60123 |
| Administrator’s telephone number | 8472545566 |
Signature of
| Role | Plan administrator |
| Date | 2022-03-31 |
| Name of individual signing | GHOUSE KAZIM |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 524210 |
| Sponsor’s telephone number | 8472545566 |
| Plan sponsor’s address | 1140 N MCLEAN BLVD STE E, ELGIN, IL, 60123 |
Plan administrator’s name and address
| Administrator’s EIN | 810731585 |
| Plan administrator’s name | G M KAZIM INSURANCE AGENCY |
| Plan administrator’s address | 1140 N MCLEAN BLVD STE E, ELGIN, IL, 60123 |
| Administrator’s telephone number | 8472545566 |
Signature of
| Role | Plan administrator |
| Date | 2021-04-24 |
| Name of individual signing | GHOUSE KAZIM |
| Valid signature | Filed with authorized/valid electronic signature |
| Name and Address | Role | Appointment Date |
|---|---|---|
| GHOUSE M KAZIM, 1140 N MCLEAN BLVD STE E, ELGIN, 60123, KANE | Agent | 2018-11-16 |
| Name and Address | Role |
|---|---|
| GHOUSE M KAZIM ; 23 CUTTERS RUN SOUTH BARRINGTON IL 60010 | President |
| Name | Change Date |
|---|---|
| G M KAZIM AGENCY, INC. | 2018-10-22 |
| Class | Series | Voting Rights | Authorized Shares | Issued Shares | Par Value |
|---|---|---|---|---|---|
| COMMON | No data | Voting Rights | 10000 | 1000000 | No data |
Date of last update: 16 Jan 2025
